NPIMap

Organization Active NPI

McLaren Bay Region

  • Family Medicine Physician
  • Rose City, MI
National Provider Identifier
1215216775
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MCLAREN BAY REGION
Practice address
2990 Campbell Rd
Rose City, MI 48654
Phone
(989) 685-2333
Fax
(989) 685-2760
NPI assigned
Aug 15, 2011
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Danielle C Jacks Porter
Title
Cfo
Phone
(989) 894-3838

Corporate family (same tax ID) 15

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
Bay Medical Center (16 organizations share this tax ID)

Locations

2990 Campbell Rd
Rose City, MI 48654
Phone (989) 685-2333

Specialties & licenses 6

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

NPPES NPI Registry

Primary practice location

2990 Campbell Rd
Rose City, MI 48654

Mailing address

2990 Campbell Rd
PO Box 527
Rose City, MI 48654-9724
Phone (989) 685-2333

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 7, 2018.

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1215216775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 CAMPBELL RD",
            "address_2": "PO BOX 527",
            "city": "ROSE CITY",
            "state": "MI",
            "postal_code": "486549724",
            "telephone_number": "989-685-2333",
            "fax_number": "989-685-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 CAMPBELL RD",
            "city": "ROSE CITY",
            "state": "MI",
            "postal_code": "48654",
            "telephone_number": "989-685-2333",
            "fax_number": "989-685-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN BAY REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-15",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "JACKS PORTER",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "989-894-3838"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rose City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.